A once-daily pill could reshape how moderate-to-severe ulcerative colitis (UC) is managed. Long-term results from the phase 2b ANTHEM-UC trial, presented at the ACG 2026 Annual Scientific Meeting, show that icotrokinra — the first-in-class oral IL-23 inhibitor — sustained strong clinical outcomes through 76 weeks. Notably, symptom remission was observed as early as week 4 and held steady or improved in nearly 80% of patients through the end of the study.

The drug's oral formulation is a significant departure from existing IL-23 inhibitors, which require injections or infusions. Experts say this could make it a more patient-friendly first-line advanced therapy, particularly for those who struggle with long-term injectable regimens.

By the Numbers:

• 56.3%–59.1% of patients achieved clinical remission at week 76 across all doses
• 63.6%–68.2% showed endoscopic improvement at week 76
• 97% of week-76 remitters were corticosteroid-free
• 85% of patients remained on treatment through week 76
• No new safety signals, serious adverse events, infections, or deaths reported

Why it matters: Corticosteroids have long been a go-to for UC, but they come with serious long-term side effects and don't sustain remission. An oral agent that matches injectable IL-23 inhibitors in efficacy — while keeping patients steroid-free and infection-risk low — could meaningfully improve quality of life for the millions living with inflammatory bowel disease.